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The stubborn polyp cases are ‘different’

The widely different behaviour of nasal polyp disease between patients is a major feature of rhinology practice and makes counselling of patients difficult when approaching their first operative intervention. Setting aside aspirin sensitivity (Samter’s triad), which is known to be...

Cummings Otolaryngology: Head and Neck Surgery: Seventh Edition - Volumes 1-3

It’s no secret Cummings Otolaryngology: Head and Neck Surgery is amongst the most widely recognised international texts on the subject. This edition does not disappoint, and provides a truly comprehensive evidence-based evaluation of topics in general otolaryngology, facial plastic and...

A viable solution for isolated post-nasal drip?

This retrospective, single-centre case series looked at a cohort of patients with postnasal drip as their primary symptom. Exclusions were patients with chronic rhinosinusitis. The interventions offered were temperature-controlled radio frequency (TCRF) ablation of the posterior nasal nerve delivered by...

What are the best minimal surgical techniques used for concha bullosa?

This prospective endoscopic and radiologic evaluation studied 42 patients who underwent concha bullosa surgery, amounting to a total of 55 conchae surgeries. The patients were allocated consecutively to either of the two groups. The presurgical and one year postsurgical endoscopic...

Comparing patient and surgeon concerns in sinus surgery

This prospective observational study had a total of 180 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with or without polyposis. Data was analysed using descriptive statistics and analysis of variance. Subjects felt the greatest level of concern regarding potential...

Passive smoking and rhinosinusitis

One would expect that subjects exposed to more passive smoke would have a significantly increased level of rhinosinusitis. This study looked at a reasonable number of sinusitis and control subjects (404 and 165) using hair nicotine as an assessment of...

Evidence and nasal polyp treatments

The change in the routine management of nasal polyps in the past 2-3 decades has been fascinating and this review from Charleston covers the topics of systemic treatment, local treatment, perioperative treatment and immunotherapy and touches on the lower airway...

Improving smell outcomes after sinus surgery: impregnated dressings?

There is much we can do to improve the airway of patients with chronic sinus disease, especially those with polyps. However, the olfactory outcomes are usually disappointing and patients miss this important sensory modality, which has an effect on their...

Posterior nasal neurectomy – long-term data shows tailing off of benefits but still improvement after three years

It is well understood that allergic rhinitis has a very detrimental effect on quality of life for afflicted patients. This study looks at patients with allergic rhinitis but no other associated sinonasal or respiratory diagnoses. Patients with a history of...

Congenitally anosmic patients do have fewer olfactory foramina

It has been previously established that patients with Kallman’s syndrome (very much associated with anosmia) have a similar number of cribriform plate foramina when compared to controls. As non-invasive CT assessment of the cribriform plate is now possible in cadavers,...

Recalcitrant chronic rhinosinusitis: What to do next?

Whilst the majority of patients with chronic rhinosinusitis (CRS) will significantly improve with treatment, we are sometimes left with a ‘hard-core’ of nasal cripples who fail to improve despite our best efforts. How can we deal with these patients? Valerie...

Chronic rhinosinusitis management: back to the future?

Immunology is a dim and distant medical school memory to many ENT surgeons, but the increasingly complex immunology of chronic rhinosinusitis is fascinating (honestly!). Medical management options in CRS no longer just involves saline and steroids, and we need to...